Individual
DR. KYLE R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
EMILE 42ND ST, OMAHA, NE 68198-4455
(402) 559-4081
(402) 559-7372
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-6195
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29237
NE
207L00000X
Anesthesiology Physician
55266-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912140674
—
WI
Enumeration date
04/10/2009
Last updated
05/13/2016
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